Paranoid Psychosis: Prevalence And Features In A Mental Health Disorder

Paranoia is a symptom that most often occurs with psychotic disorders, where psychosis is the primary symptom. Paranoia occurs when someone believes, without proof, that someone is intentionally lying or trying to harm them. In this article we’ll explore the relationship between paranoia and psychosis.

Wondering how to manage symptoms of paranoid psychosis?

Talk with a licensed therapist

What is paranoid psychosis? 

Paranoid psychosis is a mental state and collection of symptoms that can cause anxious thoughts and feelings involving themes of persecution, perceived threats, conspiracy, or imminent threat. While symptoms of paranoia may present in many mental health conditions, they often accompany delusional disorder and other psychotic disorders. 

Anyone can become suspicious of others in certain situations, and in some cases, mistrust may be warranted by an individual's circumstances. However, believing that others intend to harm or interfere with you despite evidence to the contrary can be isolating and detrimental to mental health. A person with paranoid delusions, for example, may hold false beliefs that are difficult to disprove given evidence to the contrary. While some delusions involve paranoia, others do not. In addition, for psychosis to be labeled “paranoia psychosis” other psychotic symptoms must also be present, such as hallucinations and severe delusions. 

What are common delusions associated with paranoid psychosis symptoms?

A person experiencing paranoid delusions may have very strong false beliefs that they won’t change, despite being shown evidence that proves their belief to be untrue. Some common delusions experienced by people with delusional disorder include:

Delusional jealousy in paranoid psychosis and schizophrenia

Believing that one's partner is unfaithful, a common symptom of delusional jealousy, is often seen in individuals with paranoid psychosis or schizophrenia. It is a fixed belief that persists despite clear evidence to the contrary.

Persecutory delusions in psychotic and mental disorders

Believing that someone is conspiring against them, by attacking, harassing, or impeding them from achieving their goals, is a common feature of persecutory delusions often found in psychotic disorders. 

Grandiosity delusions

Believing that one is especially important or superior to others, possessing immense and unusual talent, power, knowledge, or skills are symptoms of grandiose delusions. This type of delusion often fuels risky behavior, as the individual may believe they are invincible or immune to consequences. 

Thought broadcasting delusions in paranoid symptoms

Believing that others can perceive one's thoughts is part of thought-broadcasting delusions. This belief can lead to social withdrawal, as individuals may avoid interactions out of fear that their thoughts are being exposed. 

Thought insertion delusions in paranoia

Believing that an exterior source has infiltrated their mind is evidence of thought insertion delusions. This delusion can lead to a profound sense of loss of control, as the individual believes an outside entity is manipulating their thoughts.

Somatic delusions

Somatic delusions involve believing that something is wrong with their body, such as believing one has lost control of one's limbs. 

A belief must fall outside one's cultural context to be considered a delusion. For example, what may be regarded as an unusual belief in one culture may be widely accepted in another culture or social context.

What are symptoms of psychotic disorders or psychosis?

Psychosis is a group of symptoms that affect or distort one's perception of reality. During a psychotic episode, a person may have difficulty perceiving reality as others typically view it. Symptoms may include:

Delusions

Delusions are firm and false beliefs that are not easily swayed. 

Hallucinations

Hallucinations are sensory perceptions that are not truly occurring, such as seeing, hearing, or perceiving stimuli others can’t.

Disorganized behavior

Other symptoms, such as incoherent or nonsensical speech and behavior, may be considered inappropriate by others.

Someone with psychosis might also experience a loss of motivation, confusion, anxiety, and difficulty with daily functioning. 

Symptoms prior to the onset of psychosis

Before a person develops psychosis, they may experience gradual changes involving:

• Paranoia or suspiciousness
• Challenges with logical thinking 
• Social withdrawal or a desire to spend more time alone
• Unusual feelings, sensations, or ideas
• The absence of emotions 
• Less interest or attention to self-care and hygiene
• Sleep disturbances
• Difficulty with communication
• Reduced performance at school or work
• Challenges differentiating what is real from what is not

The relationship between paranoia and psychosis

Paranoia can be considered a feature in some mental health conditions—from schizophrenia spectrum disorders to bipolar disorder and delusional disorder. Characterized as a "key symptom" in psychosis, it may be partially linked to adverse early life experiences and an insecure attachment style. 

Psychosis is not considered a mental health condition in and of itself; instead, it relates to a group of symptoms that may accompany some mental disorders. According to recent findings, borderline personality disorder (BPD) is associated with the highest score on the Brief Symptom Inventory (BSI) in paranoid ideation. Some people with BPD may experience psychosis. However, psychosis is not a criterion for this condition. 

Psychosis and bipolar disorder

Bipolar disorder is a mental health condition characterized by extreme mood swings that include emotional highs (mania) and emotional lows (depression). During mood episodes, people with bipolar disorder may have difficulty with their energy levels, behavior, and thought patterns. 

Sometimes, people with bipolar disorder may experience symptoms of psychosis during a mood episode, like delusions. 

How is paranoid psychosis treated?

Psychosis is often treated with antipsychotic medication and talk therapy. People with severe symptoms may need to be treated with medication before starting talk therapy.  

Wondering how to manage symptoms of paranoid psychosis?

Talk with a licensed therapist

Considering therapy and treatment

If you or someone you know are at risk for developing psychosis or are experiencing symptoms, seek out a psychiatric evaluation. Seeing a therapist can also be invaluable for finding ways to manage stress and reexamine how situations may be perceived and addressed. 

Some people who experience delusional psychosis may have difficulty trusting others, including a therapist. With online therapy, you can attend sessions with a licensed therapist from the comfort of your home in the format you prefer, such as by phone, video, or messaging.

Research shows that online therapy may help reduce symptoms of psychosis. Researchers analyzed the results of 61 studies to better understand how someone with psychosis may engage with online therapy and the impact that online therapy may have on psychosis symptoms. The analysis reveals that online therapy may help reduce symptoms of psychosis, such as depression and auditory hallucinations.